Clsd/shoulder dislo/manip/no anest 23650 at WellSpan Good Samaritan Hospital

252 S. 4th St., Lebanon, PA · Wellspan · · NPI 1407928500

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 17, 2026

$595.20

Cash price

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Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

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What you pay up front if you don't use insurance.

$744.00

Gross charge

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Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$123.75 with UPMC_Medicaid vs $1,616.00 with Blue_Cross — same scan, same building. Share

Negotiated rates by payer
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Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
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Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
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Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
UPMC_Medicaid All_Plans $123.75 ↓ -79%
Geisinger_Medicaid All_Plans $123.75 ↓ -79%
Health_Partners_Medicaid All_Other_Plans $123.75 ↓ -79%
Highmark_Wholecare_Gateway_Medicaid All_Plans $123.75 ↓ -79%
PA_Health_&_Wellness_Medicaid All_Plans $123.75 ↓ -79%
Amerihealth_Caritas_Medicaid All_Plans $140.58 ↓ -76%
Blue_Cross_BlueJourney_Medicare All_Plans $236.96 ↓ -60%
Highmark_Medicare All_Plans $239.33 ↓ -60%
Aetna_Medicare All_Plans $244.07 ↓ -59%
Aetna_Advantra_Medicare All_Plans $244.07 ↓ -59%
Geisinger_Gold_Medicare All_Plans $248.81 ↓ -58%
United_Medicare ISNP_DSNP_Plans $248.81 ↓ -58%
Devoted_Medicare All_Plans $248.81 ↓ -58%
Highmark_Wholecare_Gateway_Medicare All_Plans $249.87 ↓ -58%
UPMC_Medicare UPMC_for_Life_Community_HealthChoices $249.99 ↓ -58%
Amerihealth_Medicare All_Plans $249.99 ↓ -58%
UPMC_Medicare UPMC_for_Life_Complete_Care $249.99 ↓ -58%
PA_Health_&_Wellness_Medicare All_Plans $255.92 ↓ -57%
Jefferson_Health_Medicare_Advantage All_Plans $255.92 ↓ -57%
Aetna_Better_Health_Kids All_Plans $336.60 ↓ -43%
Highmark Higmark_Healthy_Kids $367.29 ↓ -38%
Health_Partners_Medicaid Kidz_Partners $390.98 ↓ -34%
United_Medicaid Community_Plan_For_Kids $414.68 ↓ -30%
WellSpan_Capital_Blue_Cross All_Plans $446.40 ↓ -25%
UPMC Employees_And_Dependents $446.40 ↓ -25%
UPMC UPMC_For_Kids $446.40 ↓ -25%
Geisinger All_Plans $446.40 ↓ -25%
Cigna All_Plans $474.82 ↓ -20%
PHC All_Plans $595.20 ↑ +0%
Aetna All_Plans $604.13 ↑ +2%
First_Health_Network All_Plans $664.39 ↑ +12%
United_Healthcare All_Plans $697.87 ↑ +17%
Highmark Performance_Blue $716.73 ↑ +20%
Highmark Choice_Blue_PPO $716.73 ↑ +20%
Highmark Blue_Cross_High_Performance_Network $716.73 ↑ +20%
Highmark All_Other_Plans $863.55 ↑ +45%
Blue_Cross Capital_Cares_4_kids $1,131.20 ↑ +90%
Blue_Cross Capital_Blue_Performance_PPO $1,209.00 ↑ +103%
Blue_Cross Capital_Blue_Cross_Healthy_Benefits_PPO $1,292.80 ↑ +117%
Blue_Cross All_Other_Plans $1,616.00 ↑ +172%

Visitor-reported prices

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Clsd/shoulder dislo/manip/no anest 23650 at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $2,425.80 $99.00 – $3,234.40
UPMC Bedford Everett $1,214.40 $82.51 – $1,821.60
UPMC Carlisle Carlisle $856.20 $125.73 – $1,212.95
UPMC Cole Coudersport $1,266.00 $68.75 – $771.51
UPMC Community Osteopathic Harrisburg $856.20 $125.73 – $1,731.91
UPMC East Monroeville $2,281.20 $108.90 – $3,041.60
UPMC Hamot Erie $2,337.60 $108.90 – $557.45
UPMC Northwest Seneca $1,632.60 $108.90 – $516.86

All Pennsylvania hospitals for this procedure →